Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy

J Am Coll Surg. 2006 Jun;202(6):874-80. doi: 10.1016/j.jamcollsurg.2006.02.028.

Abstract

Background: Most studies comparing surgical results of laparoscopic procedures for gastric cancer with open gastrectomies have been conducted based on limited experience. We aimed to compare laparoscopy-assisted distal gastrectomy (LADG) and conventional open distal gastrectomy (ODG) after a protracted learning experience.

Study design: We retrospectively reviewed medical records data. Two hundred fifty six patients underwent distal gastrectomies (136 LADG, 120 ODG). There were 150 early gastric cancer (EGC) patients (120 LADG, 30 ODG).

Results: Mean operation times for LADG and ODG were similar among EGC (156.5 versus 159.3 minutes, p = 0.666). Mean retrieved lymph node counts for LADG and ODG were different, but were > 30 (31.3 versus 40.4 for all and 30.4 versus 38.1 for EGC). For all subjects or EGC patients after LADG, C-reactive proteins on day 5 were substantially lower, first liquid diet was resumed substantially sooner, and postoperative hospital stays were substantially shorter than for ODG.

Conclusions: LADG with lymph node dissection after a learning curve has several advantages compared with ODG, namely, less inflammatory reaction, rapid return of gastrointestinal function, and shorter hospital stay without compromising operation time or operative curability.

Publication types

  • Comparative Study

MeSH terms

  • Female
  • Follow-Up Studies
  • Gastrectomy / methods*
  • Humans
  • Laparoscopy*
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stomach Neoplasms / surgery*
  • Treatment Outcome